Amazing India

[SAPPORO]

In the US, even a homeless person would get the top-notch treatment for free in any hospital if he is admitted into ER - as proven time and again by affluent Desis that take their ailing parents to ER for life-saving surgeries and recuperation for weeks, all for free! Indians somehow think that safety net programs like Ayush-whatever is invented by them, it has been there in the US for 60 years. Anything of value would be up for corruption in India, these new programs are still not there yet.
Let's not forget that mostly poor (other than NRIs) move to other countries from the US for 'better' healthcare as opposed to rich from all over the world come to US for their specialized treatments. There are 5 hospitals within 5 miles of me all with a setting like open-air outlet malls. More importantly, if there is an emergency drivers would be courteous enough to let the ambulance pass thru which is not the case in India. Speaking of ambulances, I have been on ambulances a couple of times in India, and they are utterly ill-equipped. So, no India for me even if it's all free even though I am a bargain hunter. Another horrible thing in India is there is no accountability, and recourse should something go wrong. Instead, I will wait for my specialist appointments and in the worst case, go to the ER.

Lastly, if something works for you, just say it's good for you instead of proclaiming it's the greatest in the world. We have beaten to death the issues with the US healthcare in various forum threads. It's time we do that to the Indian system instead of assuming by default that it's the greatest in the world if one has 'connections'!

[r2somewhere]

You can get all the specialists you want with concierge health services in the US. Only thing is, you need to shell out 10k+ per month. Easily doable if you are relatively as rich in US as you are in India.

[Returning_Indian]

Weather in India since October is almost perfect. Not hot, not cold. Now the chill is coming up. But India being a sunny country, it's amazing to enjoy the Sun in this cold weather. So far light jacket does the trick. I see people sitting in the park downstairs from elderly to young. Some families even doing a small picnic. Swimming pool is obviously closed. I wish our society has a heated one but that would be big ask as it's all open. There are some nearby which are indoor and heated. Weather will stay this good till end of Mar/mid April, depending on global warming effects and then the dreaded heat will show up followed by monsoon.
After living in UK is now I appreciate sun so much more. How important sun is to uplift the mood. I thought I liked UK's dim sky but now I like sun better. For anyone visiting north India, this is probably the best time. And surprisingly it's snowing in regions like Shimla right now. Food is awesome to eat in winter as well without worrying about it going bad like in monsoon season. Chill outside does remind me of UK. It's not super cold like US but just enough to enjoy. My walking routine is in full swing except that I don't have to wake up at 5 to go. I can go for my 10km walk anytime of the day. I sometimes do feel this long walk is waste of time when compared to my gym routine. But long walk keeps my digestion healthy and clears my head and uplifts my mood. My gym classes mostly help with my muscle preservation. Cultfit offers good gym classes and it has all the corporate hotties attending. Classes after 9ish include mostly hotties who are housewives. Hoping for some Bollywood love story to unfold. In any case, planning for a video food log with a friend of mine. Maybe Amritsar or Delhi would be first to explore. He is a big executive in a big company here and has appeared on TV sometimes, but keen to be infront of camera for food log. I am YouTube shy and enjoy my privacy. So let's see how we manage it and when. But if you suddenly see a rising YouTube channel focused on food in coming months then you would know who it is.

Planning for a small trip with my brother. Boys only. December is best time as work slows down and weather is nice. Thinking of Goa but let's see.
Recently court system has remanded municipality in Gurgaon for not maintaining cleanliness. Hopefully this should bring change. In court hearing mcg commissioner didn't even know how many landfills, water treatment plants, cleaning staff, trucks etc etc does mcg have. Forget about their estimate of waste being generated. I remember back in early 2000s US cities were where Gurgaon was. Cities in US were dumping waste in rivers and solid waste in landfill. It was only after some strict laws that they started to clean up the act. But they did it very well. Anyhow their waste collection was never this bad. India needs to build infra for collection and disposal. Rich municipality like Gurgaon should lead from front but it's disappointment. Hopefully with these court cases there may be some difference.

[old-spice2]

In the US, even a homeless person would get the top-notch treatment for free in any hospital if he is admitted into ER - as proven time and again by affluent Desis that take their ailing parents to ER for life-saving surgeries and recuperation for weeks, all for free! Indians somehow think that safety net programs like Ayush-whatever is invented by them, it has been there in the US for 60 years. Anything of value would be up for corruption in India, these new programs are still not there yet.
Let's not forget that mostly poor (other than NRIs) move to other countries from the US for 'better' healthcare as opposed to rich from all over the world come to US for their specialized treatments. There are 5 hospitals within 5 miles of me all with a setting like open-air outlet malls. More importantly, if there is an emergency drivers would be courteous enough to let the ambulance pass thru which is not the case in India. Speaking of ambulances, I have been on ambulances a couple of times in India, and they are utterly ill-equipped. So, no India for me even if it's all free even though I am a bargain hunter. Another horrible thing in India is there is no accountability, and recourse should something go wrong. Instead, I will wait for my specialist appointments and in the worst case, go to the ER.

Lastly, if something works for you, just say it's good for you instead of proclaiming it's the greatest in the world. We have beaten to death the issues with the US healthcare in various forum threads. It's time we do that to the Indian system instead of assuming by default that it's the greatest in the world if one has 'connections'!

is it burning? Wait till you get into 65 and enroll into Medicare. Then one will know how crappy US healthcare system is. Saw one friend's relative struggling in his 80s and one should have some serious illness to realize that. The guy had stomach cancer and was struggling with bills that was not covered. Bills are pretty steep for complicated diseases. Unless someone is loaded with millions it is going to be a struggle.

Free medical care is useless as it is only for homeless bankrupt people. Most members on this board will not qualify. So don't keep repeating like a broken record.

American HC is a money eating machine with min care in return. In last 30 years never had first hand experience of any serious ailment that needed surgery, admit in hospital etc. 4 months back had a taste of it. Wife complained of sever pain in the chest. Got her admitted to ER in the nearby hospital. They took her in immediately, did prelim check and determined it is not a life threatening issue. Put her in the waiting room for 3 hrs but she was still suffering from the pain. Finally she shouted at some staff that if they cannot treat her immediately she would like to go back home and rest as sitting in the lounge was painful.

That got her a room, spent two days in the hospital, angio scan and other cardiac related tests were done. No issue found and discharged. During the time nurse gave aspirin. BTW the doctors were all senior Indians in their 60s. The bill came to $52K and had to pay $250 OOP thanks to company insurance. No surgery or no cure still the bill was 52 grand. 45 lakh rupees for two days stay in the hospital. No wonder medical expenses are one of the biggest cause for bankruptcy.

[Returning_Indian]

52k is the billing amount. Doesn't mean they get paid that much by insurance. If you check it online in your account then insurance may have paid them 5k at most. But it looks like you had good insurance with low deductible. It's the deductible that kills. It also means you paid a lot in premiums via your employer. I am guessing around 25-30k per year for family. When you are an employee these premiums do not matter much. But when you work as contractor is when you realize how expensive it is. From what I have heard from others, retiring before 65 is also a problem as you have to account for $2-3k per month extra for insurance purposes. Some people I know in US just work to get good health coverage through group insurance (and ofcourse killing time) and do not really need the income. Marketplace insurances are really bad as they deny lot of claims. Just look how happy people were when United insurance CEO was murdered recently. That tells you the frustration of people with marketplace insurance. Only respite is group coverage via your employer in a big setup. Small startups cannot provide similar coverage.

US healthcare is excellent for experimental treatments. For everything else US fails really bad as they cannot provide good healthcare at affordable prices with decent outcomes. This is where universal health coverage excels as other countries provide better outcomes at one third the price. But then waiting times is a big issue in countries with universal coverage. I personally prefer US among developed countries. If you keep good insurance then you can get good treatment on time. But for Medicare in US, things are only going to get worse as coverage will only reduce over time. These universal coverage schemes have potential to bankrupt the countries. So these countries are very slowly reducing coverage and decreasing the access points where you can get those treatments. They will not make drastic changes due to vote bank politics but slowly boil the frog.

Ofcourse, all of this cannot be compared to India where you fall in top 1-2% and enjoy the luxuries. You can just walk-in even for top doctors in the country in corporate hospitals and they will treat you. You can get doctors to visit your home. Other than experimental treatments, you can get best treatments for the amount you would pay in co-pay in US.

[old-spice2]

52k is the billing amount. Doesn't mean they get paid that much by insurance. If you check it online in your account then insurance may have paid them 5k at most. But it looks like you had good insurance with low deductible. It's the deductible that kills. It also means you paid a lot in premiums via your employer. I am guessing around 25-30k per year for family. When you are an employee these premiums do not matter much. But when you work as contractor is when you realize how expensive it is. From what I have heard from others, retiring before 65 is also a problem as you have to account for $2-3k per month extra for insurance purposes. Some people I know in US just work to get good health coverage (and ofcourse killing time) and do not really need the income.

US healthcare is excellent for experimental treatments. For everything else US fails really bad as they cannot provide good healthcare at affordable prices with decent outcomes. This is where universal health coverage excels as other countries provide better outcomes at one third the price. But then waiting times is a big issue in countries with universal coverage. I personally prefer US among developed countries. If you keep good insurance then you can get good treatment on time.

Ofcourse, all of this cannot be compared to India where you fall in top 1-2% and enjoy the luxuries.

I saw the final statement from the insurance company. Actual bill was 75K and after all discounts that exists between hospital and insurance company, it was reduced to 52K. Yes if we did not have insurance may be the bill would have been 75K or higher. Her company insurance is pretty good, better than what I had. They used to pay even out of network expenses in full.

I quit working at 60 because I got bored with the work, could not take nonsense of performance appraisal/rating, management setting goals for next year etc. For the past few years hated the annual review meetings. I was rated exceeding expectation, so got good bonus and RSU. For that I had to put in lot of effort and as I age that was going down. Yes if I had to LIA I would not have resigned but continue till 65 for insurance. I switched over to wife's insurance till we wrap up everything in next quarter.

Wife is almost a decade away from Medicare, not interested in working and learning new stuff like AI which is being forced on her. Either she has to master or quit. After certain age brain refuses to learn new stuff. Here learn means getting expert level knowledge not casual reading.

We came out with the strategy to deal with insurance for the remaining period. Wife will quit on first day of the month. Two weeks notice and insurance will last for another two weeks till end of the month. That is enough time to sell cars and fly out.

Yes good employer insurance is the best way to survive in US. But wait period for specialists is still a pain. In wife's case I knew it was not an ER issue. Only way to get to a specialist same day is go to Emergency.

I misused ER and forced insurance to cough up 52 grand. If I could have got same day appt with a cardiologist, it would have cost may be 25% of the amount. I have now made healthcare expensive for rest of Americans

I guess the high cost is due to CT-angiogram they conducted. Rest it was usual ECG, cardio related tests and two days in private room. Food we brought from outside as hospital food was not palatable. Nurses used to come 2-3 times a day and give some pills, that is it.

[Returning_Indian]

Wow 52k is a lot. Maybe billing has changed in last decade. In my case bill generated for multiple things was around 500k in one year and insurance company paid around 50k. I paid my yearly deductible of 3k including copays, meds etc. I called insurance company many times just to ensure that I was not liable for rest of the 450k that they did not pay. Or maybe California is different when it comes to billing. Who knows how the whole scam works.

But then again they are paying 200-250k for nurses in California. That money has to come out of somewhere. Who knows how much doctors make in private practice.

[SAPPORO]

Lots of back and forth but still no answers to my previous questions!
- Why does it cost 40K for each tooth to be replaced for my MIL in India and what normal person can afford that?
- Why do people spend crores to get the medical degree in the first place? Is it just for a larger dowry?
- How do they recoup that cost, is it in hospital cafes just like US gas stations make most of their revenue in attached convenience stores?! AI tells me "Coffee at the Yummy Bee cafe in Apollo Hospital costs around ₹1,000 for two people. The cafe also serves pizza, sandwiches, pasta, desserts, tea, and shakes."
- If they're making it up on volume, won't the quality suffer?
- Why does one need to have 'connections' and what happens to those that don't have them?
- Why do those that cannot afford healthcare in the US move abroad but the richest of the rich come to the US for specialty care?

My take on this is similar to IT outsourcing. Mundane repetitive 'production-support' work that's relative costly in the US, get it done in India and just by staying the US, the Mission-critical work gets done in the US. The choice is clear at least for me since I can't drive in India, ambulances are ill-equipped, ambulances don't have true right-of-way and I don't have any 'connections'. Moreover, I need to prove my ability to pay first even before they start treating my emergency and that could determine life or death. YMMV.

[Returning_Indian]

Antilla cost more than 8500 crore, it takes 8500 crore to build a house in India, how can aam aadmi afford that?

[SAPPORO]

Antilla cost more than 8500 crore, it takes 8500 crore to build a house in India, how can aam aadmi afford that?

Good attempt at answering the first question. Does it mean that only one person in history had their tooth replaced in India?